Could This Once-Weekly 'Pillbox' Capsule for HIV Replace Daily Dosing?

Although substantial progress has been made in the advancement of HIV treatment and prevention, adherence remains a barrier for individuals taking medication on a frequent basis. A newly-developed once-weekly HIV treatment that delivers all antiretroviral therapeutics in 1 capsule could help improve dosing adherence for patients with the virus, according to a recent study.¹

Researchers at Massachusetts Institute of Technology (MIT) and Brigham and Women’s Hospital have developed a capsule capable of delivering a week’s worth of HIV medication in 1 dose, which could make it easier for people taking HIV treatment.

According to the researchers, their drug delivery capsule has a star-shaped structure with 6 arms that can be filled with drugs, folded inward, and encased in a smooth coating. After the capsule is swallowed, the arms unfold and gradually release the medication.

“In a way, it’s like putting a pillbox in a capsule. Now you have chambers for every day of the week on a single capsule,” Giovanni Traverso, MB, a research affiliate at MIT’s Koch Institute for Integrative Cancer Research and a gastroenterologist and biomedical engineer at Brigham and Women’s Hospital, said in a press release.²

The capsule was tested in pigs and shown to successfully lodge in the stomach and release 3 different HIV medications over a 1-week period. After all the drugs are released, the capsules then disintegrate into smaller components that can pass through the digestive tract.

In determining how a once-weekly drug could impact HIV rates in high-burden countries, the researchers used modelling to estimate the effects on new infection prevention. They found that a weekly dose compared with a daily dose could improve the efficacy of HIV preventive treatment by approximately 20%. When figured into a computer model of HIV transmission in South Africa, it showed that 200,000 to 800,000 new infection could be prevented over the next 20 years.

In addition to the HIV capsule, the researchers are working on adapting the technology for other diseases, which could potentially help address adherence issues for diseases with complex medications.

References

• Kirtane AR, Abouzid O, Minahan D, et al. Development of an oral once-weekly drug delivery system for HIV antiretroviral therapy. Nature Comm. 2018. doi:10.1038/s41467-017-02294-6.
• New drug capsule may allow weekly HIV treatment [news release]. MIT’s website. http://news.mit.edu/2018/new-drug-capsule-may-allow-weekly-hiv-treatment-0109. Accessed January 10, 2018.